thegumdr.com > Periodontal
Updates > June 2009
Dr. Rick Newhart Updates
DENTISTS
NEEDED!!!
The
Mid-Ohio
Valley
Dental
Mission
of Mercy is set for July 31 and
August
1, 2009
.
More dentists are needed to help serve the less
fortunate in dental need at WVUP. Dentists may choose from
participating in triage, anesthesia, extractions or restorative
dentistry. All materials will be provided for this event.
About 50 additional dentists are still needed for this
event! You can sign up to volunteer at
the West Virginia Health Department, by calling 1-888-550-6797 or by
going to the website www.movhd.com/dental
USING
YOUR GUMS TO TEST FOR DIABETES!?
Strauss studied the potential use
of gingival crevicular blood for measuring glucose to find
diabetic patients in approximately 46 patients from an urban
university dental clinic in
New York
. The patients were divided into two groups depending on the depth of
periodontal pocketing. Strauss found that the patients with the
deepest pocket depths, correlations between the gingival crevicular
blood and the capillary finger-stick blood, were very high.
However, in individuals who had very minimal gingival bleeding and
good oral hygiene, the correlations were low. It is believed that
there is approximately 5.7million people in the
United States
with undiagnosed diabetes. The implications here are for patients who
have high levels of gingival bleeding during initial exams or recall
visits, it may be possible to obtain painless blood glucose
readings.
J. Periodontology 2009; vol 80:
907-914
LASER
IMPLANT THERAPY
Gianelli studied the
affect of using an Nd: YAG laser to reduce the bacterial endotoxins
adherent to dental implants. This In Vitro study found that Nd:YAG
laser irradiation of the endotoxin coated implants, significantly
reduced cell activation and inflammation by immune cells. It is hoped,
that by blunting the inflammatory response, this would help limit the
amount of bone resorption and inflammation associated with implants
which are infected by periodontal bacteria.
The authors used a pulse Nd:YAG laser which
Dr. Newhart
uses.
Dr. Newhart
currently
uses the Nd:YAG laser to treat adult periodontal disease. This laser
can also be used around implants that have peri-implantitis.
J. Periodontology; vol 80: 977-984
“DOCTOR,
I’M BLEEDING!!!”
Napeñas at the University of North Carolina Medical Center,
did a retrospective cohort study using records
of patients taking anti-platelet medications to see how many
dental emergencies these patients had while they were on Aspirin,
Plavix, Ticlid or dual anticoagulant therapy. Doctors found 43
patients which had 88 invasive surgical visits, from scaling and root
planing to dental implant therapy. For these patients, they found
there were no documented episodes of post-operative bleeding
complications or phone calls to their clinic requiring extra office
visits. The authors conclude that invasive dental treatment can be
performed safely on patients who are receiving dual or single
anti-platelet therapy.
Dr.
Newhart
feels that the weakness of this study is that if the
patient went to another clinic for post-operative bleeding, it was not
recorded in this study. The author also excluded patients who are
taking Warfarin, heparin or enoxaparin. Despite this study,
Dr.
Newhart
feels that it is wise to consult with the patients’
physician for a patient who is taking anticoagulant therapy to make
sure the patient is medically stable for an invasive surgical
procedure.
JADA 2009; vol 140: 690-695
SMALL
WILL WORK!!!
Degidi studied the immediate restoration of 3.0mm
diameter Dentsply Xive implants for fixed bridgework. This
retrospective study evaluated 40 consecutive patients (18 males
and 22 females) with 93 immediately restored 3.0 Xive implants. All of
the 93 implants were placed in healed, atrophied alveolar ridges. All
of the implants were also found to be osteointegrated at the six-
month uncovering. Over a four-year period, the authors found that no
implants were lost and an average bone loss was 1.16mm over a three
year period. There were no implant fractures in the posterior maxilla.
The authors concluded that using a small diameter implant, supporting
fixed bridgework, is a safe and predictable procedure if following a
strict surgical protocol. Dr. Newhart currently uses this 3.0mm Dentsply Xive implant
system for tight alveolar spaces.
J. Periodontology; vol 80: 1006-1012
STRAWBERRIES
ON YOUR GINGIVA
A case of Wegener’s
granulomatosis (WG) presented as a single isolated lesion in the
anterior gingiva for a 64-year-old woman. WG is a rare disease, which
affects the upper respiratory tract and is characterized by vasculitis
that can lead to damage of the vital organs. Oral WG involvement is
sometimes found as a strawberry-like gingival lesion. As in this
case, the lesion was presented as a circumscribe mass, firmly attached
to the ginigva, approximately 2mm in diameter, with no radiographic
correlation. The biopsy results showed micro-abcesses and blood
vessels. The patient was treated successfully with methotrexate.
Dr. Newhart
feels all
gingival lesions should be biopsied. Timely diagnosis of this
62-year-old female may have saved her life.
J. Periodontology 2008; vol 79:
1297-1303
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